在塞内加尔见到的最酷的5项创新 | 盖茨笔记

I had an amazing trip to Senegal last month. I always love getting the chance to travel and see the remarkable work the foundation’s partners are doing firsthand. These visits leave me more energized than ever to go to work every day—and my time in Senegal was no exception.

上个月，我在塞内加尔度过了一段奇妙的旅程。我总是爱找机会旅行，亲眼目睹基金会的合作伙伴所做的出色工作。这些访问让我比以往任何时候都更加充满活力地投入到每天的工作中——我在塞内加尔的访问也不例外。

Senegal is a particularly interesting country to visit, because it has made exemplary progress improving the health of its people thanks to a focus on community-led care and many years of smart policymaking. Some of the statistics are mind-blowing: Since 1992, the country has cut its stunting rate in half. Since 2000, the number of Senegalese children who die before their 5th birthday has dropped by 70 percent. And since 2005, the number of women giving birth in health facilities has increased from 62 percent to 80 percent. It’s the perfect place to talk about progress.

塞内加尔是一个特别值得访问的国家，因为它在改善人民健康方面取得了堪称典范的进展，这要归功于对社区主导的医疗保健的重视和多年来的明智决策。一些统计数据令人惊叹：自1992年以来，塞内加尔的发育迟缓率降低了一半。自2000年以来，塞内加尔5岁以下儿童死亡人数下降了70%。自2005年以来，在医疗机构分娩的妇女人数从62%增加到80%。塞内加尔是谈论进展的绝佳范例。

One of the highlights of my visit was a trip to the Institut Pasteur de Dakar, or IPD—a research center that has been pushing the frontiers of global health for nearly a century. The facility does it all: IPD plays a key role in monitoring for disease outbreaks in the region; produces millions of diagnostics every year; serves as an educational hub for the next generation of health workers and biomanufacturing workers; and will soon resume manufacturing vaccines.

达喀尔巴斯德研究所（IPD）是我此次访问的亮点之一，近一个世纪以来，该研究中心一直在推动全球健康事业的发展。该机构的工作非常全面：IPD在监测该区域疾病暴发方面发挥关键作用、每年生产数百万种诊断产品、是下一代卫生工作者和生物制造工作者的教育中心、不久还将恢复疫苗生产。

It was inspiring to meet with brilliant Senegalese scientists who are doing remarkable work to keep their country healthy. Senegal’s health transformation is, in large part, a testament to their dedication and deep understanding of their communities, and I loved talking to them about how they’re constantly evolving to meet the needs of the moment. For example, when COVID hit in 2020, IPD quickly built up a test manufacturing facility. They’re now in the process of expanding that capacity so they can produce other essential tests, like one for measles and rubella.

与杰出的塞内加尔科学家的会面令人鼓舞，他们为保障国家健康做出了卓越的工作。塞内加尔的卫生健康转型在很大程度上得益于他们的奉献精神和对社区的深刻理解，我很高兴能与他们交谈，了解他们是如何不断发展以满足当前需求的。例如，当新冠疫情于2020年袭来时，IPD迅速建立了一个测试生产设施。目前，他们正在扩大生产能力，以便能够生产其他必要的检测，比如麻疹和风疹测试。

I was also excited to attend the annual meeting of the Grand Challenges initiative in Dakar last month. The Gates Foundation launched Grand Challenges 20 years ago with a single goal in mind: to identify the biggest problems in health and give grants to the researchers who might solve them. Our hope was to inspire more brilliant scientists to think more ambitiously about transforming health in low-income countries. We hoped to create a scientific community that had support to sustain R&D for the benefit of billions of people whose health needs had been neglected.

我也很高兴参加了上个月在达喀尔举行的“大挑战”年会。盖茨基金会20年前发起“大挑战”时只有一个目标：在全球健康领域找到最亟待解决的问题，并向有望解决这些问题的研究人员提供资助。我们希望激励更多杰出的科学家更大胆地思考如何改变低收入国家的健康状况。我们希望建立一个科学共同体，支持持续研发，造福那些健康需求被忽视的数十亿人。

In 2003, we put forth 14 Grand Challenges. The initial list included developing a vaccine that didn’t require refrigeration, creating a TB treatment for latent infection, and inventing a needle-free drug delivery system. In the years since, we’ve issued more than 200 challenges—and we even launched our first AI-specific call-to-action earlier this year.

2003年，我们发起了14项“大挑战”。最初的挑战包括开发一种无需冷藏的疫苗、创造一种治疗肺结核潜伏感染的方法、以及发明一种无针给药系统。在那此后的几年里，我们已经发起了200多项挑战——我们还在今年早些时候发起了首个专门针对人工智能的行动呼吁。

I was lucky to spend a lot of time in Senegal with amazing scientists working on the next big breakthrough. Here are 5 of the coolest innovations I saw:

我很幸运能在塞内加尔与致力于下一个重大突破的了不起的科学家们一起度过了大量的时光。以下是我看到的最酷的5项创新：

1. An AI trainer that teaches health workers in India how to treat high-risk pregnancies. Here’s a devastating statistic: One woman dies in childbirth every 2 minutes. Amrita Mahale and the team at ARMMAN are using artificial intelligence to improve the odds for new mothers in India. Their large language model will one day teach health workers how to treat high-risk pregnancies. The training chatbot can be used in both English and Telugu, and the coolest part is that it automatically adjusts to the experience level of the person using it. Whether you’re a brand-new nurse or a midwife with decades of experience, ARMMAN’s trainer can arm you with the knowledge needed to save lives.

1. 一位人工智能训练师，教授印度的卫生工作者如何治疗高危妊娠。这是一组令人震惊的数据：每两分钟就有一名女性死于分娩。Amrita Mahale和ARMMAN的团队正在使用人工智能来提高印度新生儿母亲的分娩成功率。他们的大型语言模型有一天将教会卫生工作者如何治疗高危妊娠。其聊天机器人可以使用英语和泰卢固语，最酷的部分是它会自动调整到使用它的人的经验水平。无论你是一名新护士还是拥有数十年经验的助产士，ARMMAN的训练师都可以用拯救生命所需的知识武装你。

2. A low-cost mRNA vaccine platform that puts manufacturing where it’s needed most. mRNA vaccines helped prevent millions of deaths during the height of the COVID pandemic. A company called Quantoom developed a new platform that will make it cheaper and easier to build and run factories that can be adapted to make different mRNA vaccines. I was proud to announce that the foundation is investing $40 million to scale up local mRNA vaccine manufacturing in low- and middle-income countries—which includes funding for IPD to use Quantoom’s platform. This will increase supply, lower costs, guard against the possibility of vaccine hoarding in emergencies, and provide a path for local scientists to discover and develop their own vaccines.

2. 一个低成本的mRNA疫苗平台，在最需要它们的地方投入生产。一家名为Quantoom的公司开发了一种新的平台，将使建造和运营工厂变得更便宜、更容易，这些工厂可以用于生产不同的mRNA疫苗。我很自豪地宣布，基金会将投资4000万美元，以扩大低收入和中等收入国家的本地mRNA疫苗生产规模，其中包括资助IPD使用Quantoom的平台。这将增加供应，降低成本，防止在紧急情况下囤积疫苗的可能性，并为当地科学家发现和开发自己的疫苗提供途径。

3. A new way of tracking mosquitoes on the molecular level to stop malaria. Cases of mosquito-borne diseases like malaria are increasing for the first time in decades. Although climate change is a big contributor, other reasons include conflicts and drug resistance. Fortunately, Isabella Oyier at the Kenya Medical Research Institute is fighting back against mosquito evolution. She uses molecular epidemiology to track mosquitoes who have the genes that cause drug resistance and integrate it into national malaria surveillance and monitoring efforts. This will give stakeholders more insight into where resistance is spreading—and how to stop it.

3. 一种分子级追踪蚊子以阻止疟疾的新方法。几十年来，疟疾等蚊媒疾病的发病率首次出现上升。虽然气候变化是一个重要原因，但其他原因还包括地区冲突和耐药性。幸运的是，肯尼亚医学研究所的Isabella Oyier正在对抗蚊子的进化。她利用分子流行病学追踪带有导致耐药性基因的蚊子，并将其纳入国家疟疾监测和监控工作。这将让利益相关者更深入地了解抗药性在哪里蔓延——以及如何阻止它。

4. A novel approach to treating a common microbiome disorder. Our bodies are home to more microbial cells than human cells, and the good bacteria in our microbiome play an essential role keeping bad bacteria in check. When that balance is off, you get diseases like bacterial vaginosis—a common disorder that, among other problems, can make women more susceptible to HIV infection or more likely to give birth preterm. Today’s treatments are not very effective, so I was excited to talk to Meilin Zhu and her team about a new approach they’re exploring. It uses oleic acids to inhibit the growth of a “gateway” bacteria that can lead to more bad microbes, as well as promote the growth of the good bacteria. This research is still in its early stages, but it’s promising.

4. 一种治疗常见微生物群紊乱的新方法。我们体内的微生物细胞比人体细胞还多，而微生物群中的有益细菌对抑制有害细菌起着至关重要的作用。当这种平衡失调时，就会出现细菌性阴道病等疾病——一种常见疾病，除引发其他问题外，它还会使女性更容易感染艾滋病毒或更容易早产。目前的治疗方法并不十分有效，因此我很高兴能与Meilin Zhu和她的团队讨论他们正在探索的一种新方法。它利用油酸来抑制一种“入门载体”细菌的生长——这种细菌会带来更多的有害微生物——同时促进好细菌的生长。这项研究仍处于早期阶段，但前景可期。

5. A new drug development platform that will make us better prepared for the next pandemic. Although the world made remarkable progress on vaccines when COVID struck, the same can’t be said for therapeutics. The team at Decoy Therapeutics is working to speed up the process of developing drugs with their promising new biologic platform. The idea is that lipopeptide molecules could be used to inhibit a virus’ fusion machinery and prevent it from infecting cells. If Decoy’s research pans out, scientists could one day use the platform to design therapies for novel viruses within days or even hours.

5. 一个新的药物开发平台，将使我们更好地为下一次大流行做好准备。尽管在新冠疫情暴发时，全球在疫苗方面取得了显著进展，但在治疗方面却并非如此。Decoy Therapeutics的团队正在努力利用他们前景广阔的新型生物平台加快药物开发进程。他们的想法是利用脂肽分子抑制病毒的融合机制，阻止病毒感染细胞。如果Decoy的研究取得成功，科学家们有朝一日可以利用该平台在几天甚至几个小时内设计出针对新病毒的疗法。

My time in Senegal reaffirmed my belief in the power of science and innovation. There is no question that our world faces some difficult problems. But when brilliant scientists dedicate their talents to taking on the world’s biggest challenges, progress becomes possible, and we move closer to a future when all people lead healthy lives.

我在塞内加尔的经历再次坚定了我对科学和创新力量的信念。毫无疑问，我们的世界面临着一些棘手的问题。但是，当杰出的科学家们将他们的才智用于应对世界上最大的挑战时，进步就有可能实现，我们就更接近一个所有人都过上健康生活的未来。